PMID- 36071841
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220910
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Clinical efficacy, safety, and cost of nine Chinese patent medicines combined 
      with ACEI/ARB in the treatment of early diabetic kidney disease: A network 
      meta-analysis.
PG  - 939488
LID - 10.3389/fphar.2022.939488 [doi]
LID - 939488
AB  - Objectives: To evaluate and compare the efficacy, safety, and cost of nine 
      Chinese patent medicines (CPMs) combined with angiotensin-converting enzyme 
      inhibitor (ACEI) or angiotensin receptor blocker (ARB) in treating early diabetic 
      kidney disease (DKD). Design: Systematic review and network meta-analysis. Data 
      sources: PubMed, Embase, Cochrane Library, Web of Science, clinicaltrials.gov, 
      SinoMed, Chinese Biomedicine, China National Knowledge Infrastructure, WanFang, 
      and Chongqing VIP Information databases were comprehensively searched from the 
      beginning to February 2022. Review Methods: Randomized controlled trials (RCTs) 
      including Bailing capsule (BLC); Jinshuibao capsule (JSB); Huangkui capsule 
      (HKC); Compound Xueshuantong capsule (CXC); uremic clearance granule (UCG); 
      Shenyan Kangfu tablet (SYKFT); tripterygium glycosides (TG); Keluoxin capsule 
      (KLX), and Shenshuaining tablet (SSNT) combined with ACEI/ARB for patients with 
      early DKD were reviewed. Data Synthesis: Two reviewers independently screened 
      articles, extracted data, and assessed the risk of bias. Risk ratios (RRs) and 
      mean difference (MD) were reckoned to assess dichotomous variable quantities and 
      continuous variable quantities, respectively. Using the surface under the 
      cumulative ranking curve (SUCRA), we then ranked each therapeutic regime. 
      Results: Ultimately, 160 RCTs involving 13,365 patients and nine CPMs were 
      included. UCG showed significantly higher probabilities on urinary albumin 
      excretion rate (UAER) when compared with ACEI/ARB group, with MD of -47 (95%CI) 
      (-57, -37) and SUCRA 98.0%. The CXC group achieved a remarkable improvement in 
      overall response rate (ORR) compared with ACEI/ARB (RR, 1.3, 95%CI (1.2, 1.5)) 
      with SUCRA 91.9%. SSNT could be significantly superior to ACEI/ARB group in terms 
      of serum creatinine (Scr) (-19 (-26, -12), SUCRA 99.3%) and adverse effects (AEs) 
      (0.46 (0.17, 1.1), SUCRA 82.9%). BLC showed the greatest effectiveness on 24 h 
      urinary total protein (24 h UTP) (-170 (-260, -83), SUCRA 78.5%) and triglyceride 
      (Trig) (-0.89 (-1.2, -0.53), SUCRA 97.0%). From the cost-effectiveness analysis 
      of CPMs in China, the cost of TG, SYKFT and CXC was 108, 600, and 648 RMB, 
      respectively, per 3 months and were ranked in the top three. Conclusion: UCG and 
      CXC might be the optimum selection for improving UAER and ORR, and SSNT could be 
      significantly superior to ACEI/ARB group in terms of Scr and AEs. BLC shows the 
      best curative effect on 24 h UTP and Trig. TG shows the highest 
      cost-effectiveness among the nine CPMs.
CI  - Copyright (c) 2022 Liu, Zhang and Xu.
FAU - Liu, Jiarong
AU  - Liu J
AD  - Department of Nephrology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Zhang, Xuehan
AU  - Zhang X
AD  - Department of Nephrology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Xu, Gaosi
AU  - Xu G
AD  - Department of Nephrology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
LA  - eng
PT  - Systematic Review
DEP - 20220822
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC9441488
OTO - NOTNLM
OT  - Chinese patent medicines
OT  - adverse effects
OT  - diabetic kidney disease
OT  - network meta-analysis
OT  - therapies
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/09/09 06:00
MHDA- 2022/09/09 06:01
PMCR- 2022/08/22
CRDT- 2022/09/08 02:15
PHST- 2022/06/01 00:00 [received]
PHST- 2022/07/18 00:00 [accepted]
PHST- 2022/09/08 02:15 [entrez]
PHST- 2022/09/09 06:00 [pubmed]
PHST- 2022/09/09 06:01 [medline]
PHST- 2022/08/22 00:00 [pmc-release]
AID - 939488 [pii]
AID - 10.3389/fphar.2022.939488 [doi]
PST - epublish
SO  - Front Pharmacol. 2022 Aug 22;13:939488. doi: 10.3389/fphar.2022.939488. 
      eCollection 2022.